A new methodology based on functional principal component analysis to study postural stability post-stroke

M Luz Sánchez-Sánchez; Juan-Manuel Belda-Lois; Silvia Mena-Del Horno; Enrique Viosca-Herrero; Celedonia Igual-Camacho; Beatriz Gisbert-Morant

doi:10.1016/j.clinbiomech.2018.05.003

A new methodology based on functional principal component analysis to study postural stability post-stroke

Clin Biomech (Bristol, Avon). 2018 Jul:56:18-26. doi: 10.1016/j.clinbiomech.2018.05.003. Epub 2018 May 5.

Authors

M Luz Sánchez-Sánchez¹, Juan-Manuel Belda-Lois², Silvia Mena-Del Horno³, Enrique Viosca-Herrero⁴, Celedonia Igual-Camacho⁵, Beatriz Gisbert-Morant⁶

Affiliations

¹ Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, Gascó Oliag street, 5, 46010, Valencia, Spain. Electronic address: M.Luz.Sanchez@uv.es.
² Biomechanics Institute of Valencia, Universitat Politécnica de Valéncia, Camí de Vera s/n, edificio 9C, 46022, Valencia, Spain. Electronic address: Juanma.belda@ibv.upv.es.
³ Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, Gascó Oliag street, 5, 46010, Valencia, Spain. Electronic address: Silvia.Mena@uv.es.
⁴ Hospital Universitari i Politècnic La Fe, Avinguda de Fernando Abril Martorell, 106, 46026, Valencia, Spain. Electronic address: viosca_enr@gva.es.
⁵ Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, Gascó Oliag street, 5, 46010, Valencia, Spain. Electronic address: Celedonia.Igual@uv.es.
⁶ Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, Gascó Oliag street, 5, 46010, Valencia, Spain. Electronic address: Beatriz.Gisbert@uv.es.

PMID: 29775954
DOI: 10.1016/j.clinbiomech.2018.05.003

Abstract

Background: A major goal in stroke rehabilitation is the establishment of more effective physical therapy techniques to recover postural stability. Functional Principal Component Analysis provides greater insight into recovery trends. However, when missing values exist, obtaining functional data presents some difficulties. The purpose of this study was to reveal an alternative technique for obtaining the Functional Principal Components without requiring the conversion to functional data beforehand and to investigate this methodology to determine the effect of specific physical therapy techniques in balance recovery trends in elderly subjects with hemiplegia post-stroke.

Methods: A randomized controlled pilot trial was developed. Thirty inpatients post-stroke were included. Control and target groups were treated with the same conventional physical therapy protocol based on functional criteria, but specific techniques were added to the target group depending on the subjects' functional level. Postural stability during standing was quantified by posturography. The assessments were performed once a month from the moment the participants were able to stand up to six months post-stroke.

Findings: The target group showed a significant improvement in postural control recovery trend six months after stroke that was not present in the control group. Some of the assessed parameters revealed significant differences between treatment groups (P < 0.05).

Interpretation: The proposed methodology allows Functional Principal Component Analysis to be performed when data is scarce. Moreover, it allowed the dynamics of recovery of two different treatment groups to be determined, showing that the techniques added in the target group increased postural stability compared to the base protocol.

Trial registration: ClinicalTrials.gov NCT02250040.

Keywords: Functional Principal Component Analysis; Postural stability; Posturography; Romberg; Stroke.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Double-Blind Method
Female
Hemiplegia / physiopathology*
Hemodynamics
Humans
Least-Squares Analysis
Male
Middle Aged
Observer Variation
Physical Therapy Modalities
Postural Balance*
Principal Component Analysis
Reproducibility of Results
Stroke / physiopathology*
Stroke Rehabilitation / methods*
Treatment Outcome

Associated data

ClinicalTrials.gov/NCT02250040